Provider Demographics
NPI:1316238736
Name:CAO, TU TUAN (DO)
Entity type:Individual
Prefix:
First Name:TU
Middle Name:TUAN
Last Name:CAO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WALL ST
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-2942
Mailing Address - Country:US
Mailing Address - Phone:844-404-4787
Mailing Address - Fax:815-936-3243
Practice Address - Street 1:3270 JOE BATTLE BLVD STE 215
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2651
Practice Address - Country:US
Practice Address - Phone:915-206-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144807207RC0000X
WAOP61019920207RC0000X
OH34.014221207RC0000X
WI83-321207RC0000X
OK390200000X
TXS5571207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100094664Medicaid
TX1316238736Medicaid
NM76053202Medicaid